Prostatitis is swelling and inflammation of a walnut-sized gland called the prostate gland, situated directly below the bladder in men. The prostate gland produces fluid (semen) that nurtures and transports sperm.
Prostatitis often leads to pains while passing out urine. Other symptoms include pain in the groin, pelvic area or genitals and sometimes flu-like symptoms.
Prostatitis tends to be more common in men 50 or younger. The condition has a number of causes. Sometimes the cause remains unidentified.
Depending on the cause, prostatitis can come on gradually or suddenly. It might improve quickly, either on its own or with treatment.
Symptoms of Prostatitis
The signs and symptoms of prostatitis depends on the cause. They can include:
- Pain or burning sensation when urinating (dysuria)
- Painful ejaculation
- Blood in the urine
- Difficulty passing out urine
- Frequent urination at night (nocturia)
- Urgent need to urinate
- Cloudy urine
- Pain in the abdomen, groin or lower back
- Pain in the area between the scrotum and rectum (perineum)
- Pain or discomfort of the penis or testicles
- Flu-like symptoms (with bacterial prostatitis)
Causes of Prostatitis
Acute bacterial prostatitis is regularly caused by common strains of bacteria. The infection can begin when bacteria in urine seep into your prostate. The infection can be treated with antibiotics. If they don’t get rid of the bacteria prostatitis, might return or be difficult to treat, leading to chronic bacterial prostatitis.
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Surgery or trauma can cause nerve damage in the lower urinary tract, which can contribute to prostatitis not caused by a bacterial infection. In many cases of prostatitis, the cause isn’t identified. There’s actually no direct evidence that prostatitis can lead to prostate cancer.
Risk factors for prostatitis include:
- Being a young or middle-aged
- Having HIV/AIDS
- Having had a prostate biopsy
- Having had prostatitis
- Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
- Having pelvic trauma, such as an injury from bicycling or horseback riding
- Using a tube inserted into the urethra to drain the bladder (urinary catheter)
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Complications of prostatitis can include:
- Bacterial infection of the blood
- Semen abnormalities and infertility Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
- Pus-filled cavity in the prostate (prostatic abscess)
Other conditions would have to be ruled out as the possible cause of your symptoms when diagnosing prostatitis. Diagnosis will also identify what kind of prostatitis you have. Your doctor will ask about your medical history and your symptoms and perform a physical exam, which will likely include a digital rectal examination.
Initial diagnostic tests might include:
- Urine tests:A sample of your doctor might be analyzed to check for signs of infection in your urine (urinalysis). Your doctor might also send a sample of your urine to a lab to check if you have an infection.
- Blood tests:Your doctor might examine samples of your blood for symptoms of infection and other prostate problems.
- Post-prostatic massage:Your doctor might massage your prostate and test the secretions in rare cases.
- Imaging tests:Your doctor might order a CT scan of your urinary tract and prostate or a sonogram of your prostate. CT scan images provide more thorough information than plain X-rays do. A sonogram is the visual image produced by an ultrasound.
Based on your symptoms and test results, your doctor might conclude that you have one of the following types of prostatitis:
- Acute bacterial prostatitis:This is caused by common strains of bacteria, and generally starts suddenly and causes flu-like symptoms, such as fever, chills, nausea and vomiting.
- Chronic bacterial prostatitis:You can develop recurring prostatitis when antibiotics don’t kill the bacteria. Between attacks of chronic bacterial prostatitis, you might have no symptoms or only minor ones.
- Chronic prostatitis/chronic pelvic pain syndrome:This is the most common type of prostatitis that isn’t caused by bacteria. Often an exact cause can’t be identified. For some men, symptoms stay about the same over time. For others, the symptoms go through cycles of being more and less severe.
- Asymptomatic inflammatory prostatitis:This type of prostatitis doesn’t cause symptoms and is usually found only by chance when you’re undergoing tests for other conditions. It doesn’t require treatment because it resolves on its own.
Prostatitis treatments depend on the underlying cause. They can include:
- This is the most commonly prescribed treatment for prostatitis. Your doctor will choose your medication based on the type of bacteria causing your infection. If you have severe symptoms, you might need intravenous (IV) antibiotics. You’ll likely need to take oral antibiotics for four to six weeks but might need longer treatment for chronic or repeated prostatitis.
- Alpha blockers.These medications help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease symptoms, such as painful urination.
- Anti-inflammatory agents.Nonsteroidal anti-inflammatory drugs (NSAIDs) might make you more comfortable.
Lifestyle and home remedies
The following might ease some symptoms of prostatitis:
- Soak in a warm bath (sitz bath) or use a heating pad.
- Limit or avoid alcohol, caffeine, and spicy or acidic foods, which can cause irritation to your bladder.
- Avoid prolonged sitting or bicycling because these activities can irritate your prostrate.
- Drink plenty of caffeine-free beverages. This will cause you to urinate more and help flush bacteria from your bladder.
Alternative therapies that show some promise for reducing symptoms of prostatitis include:
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- A biofeedback specialist uses signals from monitoring equipment to teach you to control certain body functions and responses, including relaxing your muscles.
- In this method, very thin needles are inserted through your skin to various depths at certain points on your body.
- Herbal remedies and supplements.There’s no evidence that herbs and supplements improve prostatitis, although many men take them. Some herbal treatments for prostatitis include rye grass (cernilton), a chemical found in green tea, onions and other plants (quercetin) and extract of the saw palmetto plant.
Preparing for your appointment
You might start by seeing your primary care provider. Or you might be referred immediately to a specialist in urinary tract and sexual disorders (urologist).
Here’s some information to help you get ready for your appointment.
What you can do
Make a list of:
- Your symptoms,including any that might seem unrelated to the reason for your appointment, and when they began
- Key personal information,including major stresses or recent illnesses
- All medications, vitamins or other supplements you take,including doses
- Questions to askyour doctor
Take a family member or friend along, if possible, to help you remember the information you’re given.
For prostatitis, questions to ask your doctor include:
- What is causing my symptoms?
- What other conditions could be causing my pain?
- What kinds of tests will I require?
- What is the best treatment you recommend?
- Are there other treatment options?
You can also ask other needful questions that you require explanations on.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- When did you begin having symptoms?
- Are your symptoms severe?
- Have your symptoms been continuous or recurrent?
- Have you had frequent urinary tract infections in the past?
- Have you had a recent injury to your groin?